BRADLEY S KURGIS D O INC (NPI# 1366736290) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366736290 |
| Entity Type | Organization |
| Organization Name | BRADLEY S KURGIS D O INC |
| Practice Address |
1320 Las Tablas Rd Suite B Templeton CA 93465-9711 |
| Practice Telephone | 8054345563 |
| Practice Fax Number | 8054345916 |
| Mailing Telephone | 8054345563 |
| Mailing Fax Number | 8054345916 |
| Enumeration Date | 2011-06-08 |
| Last Update Date | 2020-10-26 |
| Authorized Official Name | DR. BRADLEY S KURGIS (OWNER) |
| Authorized Official Telephone | 8054345563 |
| Authorized Official Credential | DO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE ID | 20A55170 | 01 |
| Street Address |
1320 LAS TABLAS RD SUITE B |
| City | TEMPLETON |
| State | CA |
| Zip Code | 93465-9711 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730162413 | Todd Fitzgerald Lomelino | Family Medicine | 1320 Las Tablas Rd, Suite F, Templeton, CA 93465-9711 | 2005-11-27 |
| 1316410574 | Leslie Ann Kazia | Nurse Practitioner | 1320 Las Tablas Rd, Templeton, CA 93465-9711 | 2019-01-09 |
| 1003159849 | Leslie Ann Joslin | Nurse Practitioner | 1320 Las Tablas Rd, Ste F, Templeton, CA 93465-9711 | 2013-03-29 |
| 1851697833 | Randolph S Lawrence Md A Medical Corp | Specialist | 1320 Las Tablas Rd, Suite C, Templeton, CA 93465-9711 | 2011-02-08 |
| 1386948073 | Lomelino Medical Group PC | Family Medicine | 1320 Las Tablas Rd, Suite F, Templeton, CA 93465-9711 | 2011-01-10 |
| 1083869804 | Central Coast Pediatrics Inc | Pediatrics | 1320 Las Tablas Rd, Suite D, Templeton, CA 93465-9711 | 2008-11-20 |
| 1164560348 | Randolph Schuyler Lawrence | Specialist | 1320 Las Tablas Rd, Suite C, Templeton, CA 93465-9711 | 2007-02-01 |
| 1508940081 | Debra Lee Balke | Psychiatry & Neurology | 1320 Las Tablas Rd, Suite E, Templeton, CA 93465-9711 | 2006-10-24 |
| 1770529620 | Bradley S. Kurgis | Dermatology | 1320 Las Tablas Rd, Suite B, Templeton, CA 93465-9711 | 2006-06-21 |
| 1184699241 | San Luis Obispo Ca Endoscopy Asc Lp | Clinic/Center | 1320 Las Tablas Rd, Suite A, Templeton, CA 93465-9711 | 2006-02-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346773306 | Edward Delos Trino | Nurse Practitioner | 350 Posada Ln # 102, Templeton, CA 93465 | 2017-04-06 |
| 1497102883 | Miriam Castillo | Counselor | 44 Brewer St, Templeton, CA 93465 | 2016-05-16 |
| 1013395821 | Marna Moore-barr | Registered Nurse | 90 Dandelion Ln, Templeton, CA 93465 | 2015-05-12 |
| 1396007308 | Melissa Lee Gaidis | Psychologist | 225 Posada Lane, Suite L, Templeton, CA 93465 | 2012-06-14 |
| 1033418736 | Central Coast Associated Physicians, Inc. | Internal Medicine | 1220 Las Tablas Rd, Suite 1418, Templeton, CA 93465 | 2011-03-21 |
| 1922306281 | Benjamin Ernest Bartel | Counselor | 1827 Orlen Lane, Templeton, CA 93465 | 2011-03-09 |
| 1003116674 | Tiffney Taylor | Internal Medicine | 265 Posada Ln Ste B, Templeton, CA 93465 | 2010-10-28 |
| 1124355342 | Mary Christine Schaff | Nurse Practitioner | 1111 Las Tablas Rd., Ste. M, Templeton, CA 93465 | 2009-11-09 |
| 1417196890 | Liberty Michael Romig | Marriage & Family Therapist | 318 Crocker Street, Templeton, CA 93465 | 2009-02-09 |
| 1427212273 | Linda Kay Shaleen | Social Worker | 212 Main Street Suite 201, Templeton, CA 93465 | 2008-07-10 |
| Find all providers in zip 93465 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902095847 | Carmelo Plateroti, D.o., A Professional Corporation | Dermatology | 1101 Las Tablas Rd Ste G, Templeton, CA 93465-9731 | 2007-10-16 |
| 1770529620 | Bradley S. Kurgis | Dermatology | 1320 Las Tablas Rd, Suite B, Templeton, CA 93465-9711 | 2006-06-21 |
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| 1518447689 | Razieh Soltani Arabshahi Md Inc | Dermatology | 960 E Green St Ste 330, Pasadena, CA 91106-2401 | 2018-08-18 |
| 1811497928 | Laca Dermatology, Inc | Dermatology | 4955 Van Nuys Blvd Ste 516, Sherman Oaks, CA 91403-1832 | 2018-02-15 |
| 1427509959 | Northern California Medical Assoc Inc | Dermatology | 555 S Dora St Ste B, Ukiah, CA 95482-5424 | 2016-10-19 |
| 1376091553 | Integrated Dermatology of Mission Viejo, Apmc | Dermatology | 26691 Plaza Ste 230, Mission Viejo, CA 92691-6300 | 2016-09-15 |
| 1164835518 | Laila Elkeeb, M.d., Inc | Dermatology | 242 Wicker, Irvine, CA 92618-1170 | 2014-06-03 |
| 1518303924 | Christine Shaver | Dermatology | 1301 20th St Ste 570, Santa Monica, CA 90404-2118 | 2013-05-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.